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2022 ◽  
Vol 07 (01) ◽  
pp. 37-41
Author(s):  
Ramdas Ransing ◽  
Sujita Kumar Kar ◽  
Vikas Menon

In recent years, the Indian government has been promoting healthcare with an insufficient evidence base, or which is non-evidence-based, alongside delivery of evidence-based care by untrained practitioners, through supportive legislation and guidelines. The Mental Health Care Act, 2017, is a unique example of a law endorsing such practices. In this paper, we aim to highlight the positive and negative implications of such practices for the delivery of good quality mental healthcare in India.


Weed Science ◽  
2021 ◽  
pp. 1-23
Author(s):  
John R. Brewer ◽  
Jordan C. Craft ◽  
Shawn D. Askew

Abstract Immediate, post-treatment irrigation has been proposed as a method to reduce hybrid bermudagrass [Cynodon dactylon (L.) Pers. x Cynodon transvaalensis Burtt Davy] phytotoxicity from topramezone. Immediate irrigation is impractical since it would take a turfgrass sprayer 10 to 15 minutes to cover an average golf course fairway or athletic field. There is also insufficient evidence regarding how post-treatment irrigation, immediate or otherwise, influences mature goosegrass [Eleusine indica (L.) Gaertn.] control from topramezone or low-dose topramezone plus metribuzin programs. We sought to investigate bermudagrass and E. indica response to immediate, 15-minute, and 30-minute post-treatment irrigation compared to no irrigation following topramezone at 12.3 g ae ha−1, the lowest labeled rate, or topramezone at 6.1 g ha−1 plus metribuzin at 210 g ai ha−1. We also evaluated placement of each herbicide and their combination on soil, foliage, and soil plus foliage to help elucidate the mechanisms involved in differential responses between species and herbicide mixtures. Responses were largely dependent on trial due to bermudagrass injury from high-dose topramezone being nearly eliminated by immediate irrigation in one trial and only slightly affected in another. When post-treatment irrigation was postponed for 15 or 30 minutes, topramezone alone injured bermudagrass unacceptably in both trials. Bermudagrass was injured less by low-dose topramezone plus metribuzin than by high-dose topramezone. All post-treatment irrigation timings reduced E. indica control compared to no post-treatment irrigation. The herbicide placement study suggested that topramezone control of E. indica is highly dependent on foliar uptake and phytotoxicity of both bermudagrass and E. indica is greater from topramezone than metribuzin. Thus, post-treatment irrigation likely reduces topramezone rate load with a concomitant effect on plant phytotoxicity of both species. Metribuzin reduced 21-d cumulative clipping wt and tiller production of plants, and this may be a mechanism by which it reduces foliar white discoloration from topramezone.


2021 ◽  
Vol 21 (2) ◽  
pp. 1-28
Author(s):  
Paweł Sobkowiak

The qualitative research reported in this article investigated whether and to what extent students’ intercultural competence is developed in the English language classroom at the secondary education level in Poland. In interviews teachers demonstrated their positive attitudes toward intercultural teaching and decent knowledge of the issue. However, the teachers’ narratives uncovered that they assigned the interculturality the secondary role, focusing on developing linguistic and sociolinguistic competences. The collected data revealed that students in class had very few opportunities to explore foreign cultures and compare/ contrast one culture with another. There was a lack of attention to teaching that promotes critical thinking skills among learners along with activities which foster them. However, there is insufficient evidence that teachers can currently do anything more, given the context in which they work, their constraints and lack of training and support. The findings of the current study have clear implications for curriculum designers, textbook writers and institutions in charge of teacher training - EFL syllabuses, teaching materials and teacher training should focus more on developing students’ intercultural and critical thinking skills.


Gut ◽  
2021 ◽  
pp. gutjnl-2021-326452
Author(s):  
Roni F Kunst ◽  
Coen C Paulusma ◽  
Stan F J van de Graaf

Neurology ◽  
2021 ◽  
Vol 97 (23) ◽  
pp. 1072-1081
Author(s):  
David Gloss ◽  
Kimberly Pargeon ◽  
Alison Pack ◽  
Jay Varma ◽  
Jacqueline A. French ◽  
...  

ObjectiveTo update a 1996 American Academy of Neurology practice parameter.MethodsThe authors systematically reviewed literature published from January 1991 to March 2020.ResultsThe long-term (24–60 months) risk of seizure recurrence is possibly higher among adults who have been seizure-free for 2 years and taper antiseizure medications (ASMs) vs those who do not taper ASMs (15% vs 7% per the 1 Class I article addressing this issue). In pediatric patients, there is probably no significant difference in seizure recurrence between those who begin tapering ASMs after 2 years vs 4 years of seizure freedom, and there is insufficient evidence of significant difference in risk of seizure recurrence between those who taper ASMs after 18 months of seizure freedom and those tapering after 24 months. There is insufficient evidence that the rate of seizure recurrence with ASM withdrawal following epilepsy surgery after 1 year of seizure freedom vs after 4 years is not significantly different than maintaining patients on ASMs. An epileptiform EEG in pediatric patients increases the risk of seizure recurrence. ASM withdrawal possibly does not increase the risk of status epilepticus in adults. In seizure-free adults, ASM weaning possibly does not change quality of life. Withdrawal of ASMs at 25% every 10 days to 2 weeks is probably not significantly different from withdrawal at 25% every 2 months in children who are seizure-free in more than 4 years of follow-up.RecommendationsFourteen recommendations were developed.


Author(s):  
Francis Q. S. Dzakpasu ◽  
Alison Carver ◽  
Christian J. Brakenridge ◽  
Flavia Cicuttini ◽  
Donna M. Urquhart ◽  
...  

Abstract Background Sedentary behaviour (SB; time spent sitting) is associated with musculoskeletal pain (MSP) conditions; however, no prior systematic review has examined these associations according to SB domains. We synthesised evidence on occupational and non-occupational SB and MSP conditions. Methods Guided by a PRISMA protocol, eight databases (MEDLINE, CINAHL, PsycINFO, Web of Science, Scopus, Cochrane Library, SPORTDiscus, and AMED) and three grey literature sources (Google Scholar, WorldChat, and Trove) were searched (January 1, 2000, to March 17, 2021) for original quantitative studies of adults ≥ 18 years. Clinical-condition studies were excluded. Studies’ risk of bias was assessed using the QualSyst checklist. For meta-analyses, random effect inverse-variance pooled effect size was estimated; otherwise, best-evidence synthesis was used for narrative review. Results Of 178 potentially-eligible studies, 79 were included [24 general population; 55 occupational (incuding15 experimental/intervention)]; 56 studies were of high quality, with scores > 0.75. Data for 26 were meta-synthesised. For cross-sectional studies of non-occupational SB, meta-analysis showed full-day SB to be associated with low back pain [LBP – OR = 1.19(1.03 – 1.38)]. Narrative synthesis found full-day SB associations with knee pain, arthritis, and general MSP, but the evidence was insufficient on associations with neck/shoulder pain, hip pain, and upper extremities pain. Evidence of prospective associations of full-day SB with MSP conditions was insufficient. Also, there was insufficient evidence on both cross-sectional and prospective associations between leisure-time SB and MSP conditions. For occupational SB, cross-sectional studies meta-analysed indicated associations of self-reported workplace sitting with LBP [OR = 1.47(1.12 – 1.92)] and neck/shoulder pain [OR = 1.73(1.46 – 2.03)], but not with extremities pain [OR = 1.17(0.65 – 2.11)]. Best-evidence synthesis identified inconsistent findings on cross-sectional association and a probable negative prospective association of device-measured workplace sitting with LBP-intensity in tradespeople. There was cross-sectional evidence on the association of computer time with neck/shoulder pain, but insufficient evidence for LBP and general MSP. Experimental/intervention evidence indicated reduced LBP, neck/shoulder pain, and general MSP with reducing workplace sitting. Conclusions We found cross-sectional associations of occupational and non-occupational SB with MSP conditions, with occupational SB associations being occupation dependent, however, reverse causality bias cannot be ruled out. While prospective evidence was inconclusive, reducing workplace sitting was associated with reduced MSP conditions. Future studies should emphasise prospective analyses and examining potential interactions with chronic diseases. Protocol registration PROSPERO ID #CRD42020166412 (Amended to limit the scope)


2021 ◽  
Vol 29 (6) ◽  
pp. 331-340
Author(s):  
THIAGO SANCHEZ PIRES BUENO ◽  
GABRIEL PARIS DE GODOY ◽  
REBECA BARROS FURUKAVA ◽  
NICOLE TAKAKURA GAGGIOLI ◽  
MARCEL JUN SUGAWARA TAMAOKI ◽  
...  

ABSTRACT Objective: Heterotopic ossification is defined as the formation of trabecular bone in soft tissues. It is a common complication after surgical treatment of acetabular fractures. However, its prophylaxis and treatment are still controversial. The objective of this research is to evaluate the effectiveness of actions to prevent the development of heterotopic ossification after surgical correction of acetabular fractures. Methods: A systematic review was carried out with research in the databases PubMed/MEDLINE, Embase, LILACS and Cochrane until August 4, 2020, without restrictions on language and year of publication. Only randomized clinical studies carried out in humans without restrictions based on the dosage of treatments, use and duration of prophylaxis were included in this review. Results: Two studies compared the use of radiotherapy and indomethacin and three compared the use of indomethacin with a placebo or non-indomethacin group. The meta-analysis calculations did not indicate statistical differences between radiotherapy versus indomethacin (RR 1.45, IC 95% 0.97 to 2.17, p = 0,55) and indomethacin versus placebo or not indomethacin (RR 0.85, IC 95% 0.68 to 1.06, p = 0,59). Conclusion: There is insufficient evidence to affirm that the use of radiotherapy or indomethacin are effective to prevent the formation of heterotopic ossification after surgery for fractures of the acetabulum. In addition, the number of complications was higher in the indomethacin group when compared to placebo or no intervention. Level of Evidence I, Systematic Review.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 418-419
Author(s):  
Cathrine Moe ◽  
Elissa Burton ◽  
Lisbeth Uhrenfeldt ◽  
Hanne Leirbekk Mjøsund

Abstract The aim of this study was to map evidence of how physical activity (PA) strategies are integrated and explored in research of interdisciplinary, time-limited reablement for community dwelling older adults and to identify knowledge gaps. Following an apriori protocol, we searched eight databases for eligible studies, in addition to citation and reference searches. Study selection and data-extraction was made independently by two reviewers. Fifty-one studies were included, showing that exercises and practice of daily activities were included in the majority of intervention studies, but in most cases little information about exercise components or strategies for increasing PA were provided. There was insufficient evidence for any synthesis of how reablement affects older adults’ PA levels, their physical fitness or how PA is experienced in reablement. There is a need to further investigate how the promotion of PA can be adequately implemented in reablement and how it may affect older adults’ function.


Author(s):  
Guillaume Demey ◽  
Jacobus H. Müller ◽  
Michael Liebensteiner ◽  
Peter Pilot ◽  
Luca Nover ◽  
...  

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
M.P. Hoang ◽  
J. Samuthpongtorn ◽  
K. Seresirikachorn ◽  
K. Snidvongs

Background: There is insufficient evidence to confirm the protective effects of prolonged breastfeeding against the development of allergic rhinitis (AR). Methodology: A systematic review and meta-analysis was performed to assess the associations between prolonged breastfeeding and AR symptoms later in life. Comparisons were conducted between breastfeeding durations less than 6 months and 6 months or more and between less than 12 months and 12 months or more. Exclusive breastfeeding and nonexclusive breastfeeding were analysed separately. Outcomes were risks of AR development later in life. Results: Twenty-three observational studies (161,611 children, age 2-18 years, 51.50% male) were included. Two studies (9%) were with high quality. Both exclusive and nonexclusive prolonged breastfeeding (6 months or more) decreased the risk of AR. The long-term (12 months or more) nonexclusive breastfeeding lowered the likelihood of AR compared to the 12 months or fewer. The long-term exclusive breastfeeding did not show the same protective effect; however, this result was restricted to only one study. Conclusions: Exclusive breastfeeding and nonexclusive breastfeeding for 6 months or more may have protective effects against the development of AR up to 18 years of age. The findings should be interpreted with caution given the limitation of low-quality observational studies.


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